Method for predicting prostatic cancer
FIELD: medicine, urology.
SUBSTANCE: the present innovation deals with differential diagnostics of prostatic cancer and other prostatic diseases at the stage of primary inspection. The method includes the detection of PCA and calculation of probability coefficient for prostatic cancer (PCC) by the following formula: where e - the foundation of natural logarithm (e=2.718…), PCA - the level of total blood PCA in ng/ml, V - patient's age in years. At PCC value being above 0.2 one should diagnose prostatic cancer and to establish final diagnosis one should perform polyfocal prostatic biopsy. The method enables to increase accuracy of diagnostics at decreased number of unjustified prostatic biopsies.
EFFECT: higher efficiency of diagnostics.
The invention relates to medicine, namely, urology, and can be used for differential diagnosis of prostate cancer (PC) and other prostate diseases at primary inspection.
In Russia FPW 5% of all malignant neoplasms in men, occupying the 4th place on morbidity. Mortality from FPW is 3.9% of the total mortality from cancer. In most patients the disease is diagnosed at the stage of clinical manifestations, which often correspond to common forms of FPW. This is especially true in our country, where there is no system of annual screening or preventive examinations of men older than 50 years. Detection of PRV in the early stages gives the possibility of cure of the patient.
The most informative and accessible methods of early detection of PRV are taking a thorough history (including by means of questionnaires IPSS, QoL), digital rectal examination (Dre), transrectal ultrasound (transrectal us). These methods are well studied and successfully applied in screening surveys in many countries, allowing you to diagnose FPW already in the early stages. However, the presence of concomitant diseases of the prostate, such as benign hyperplasia of the present is part of the gland (BPH) and chronic prostatitis (CP), significantly reduce the data characteristics of diagnostic procedures. So, according to different authors, from 2.5% to 12% of patients who were excluded FPW and operated for BPH, morphologically installed FPW.
The closest analogue is the prototype of determining the probability of prostate cancer is the determination of total prostate-specific antigen (PSA) in serum. Matveev BP, Bukharin BV, Matveev V.B. have been prostate Cancer. - M., 1999.- 153 C.
However, the disadvantage of determining the level of PSA remains the fact that the DOG is organospecific, but not cancerspecific marker. This is because the reasons for the increased level of PSA in the serum, in addition to PC, can be an inflammatory process in the prostate, BPH, ischemia or infarction prostate ejaculation prior studies. It is proved that 1 g of the prostate (mud) in BPH secretes of 0.35 ng/ml PSA, while at PC, the average is 3.5 ng/ml In this regard, a small amount of cancerous lesions in the mud rising PSA level may be the same as in BPH large size. Therefore, the problem of early diagnosis of PC in patients with concomitant diseases of the prostate remains relevant.
The objective of the invention is to improve the accuracy of diagnosis of PC and the decline in the number of neopravdanno the x biopsies of the prostate.
This task is achieved by the fact that on the basis of the patient's age and the result of a blood test for levels of total prostate-specific antigen (PSA) blood count criterion of probability of cancer (CWR) and values greater 0,2, diagnose PC with subsequent prostate biopsy, when CWR less than 0.2 FPW is considered to be unlikely.
The method is as follows.
CWR is calculated by the formula
where e is the base of natural logarithm (e=2,718...);
PSA - level of total PSA blood in ng/ml;
V - the patient's age in years.
The value calculated in this way CWR, expressed in dimensionless terms, compared with the number of 0.2. If CWR is less than or equal to 0.2, then prostate cancer in this patient is considered to be unlikely. Otherwise, prostate cancer is considered probable and the patient shows a multifocal spectacle prostate biopsy to install a definitive diagnosis.
The results of examination of patients with symptoms of urinary disturbances showed that the values of the criterion significantly differ in patients with prostate cancer (CWR=0,30±0,009, n=211), and other pathologies of the prostate (CWR=0,24±0,004, n=76).
The effectiveness of this method for the diagnosis of prostate cancer has been tested in Klinicheskaya medicine, far Eastern state medical Institute. Analyzed medical history 287 men aged from 41 to 92 years old, who asked about symptoms of urinary disorder. As a result of running them on the testimony of multifocal spectacle of prostate biopsy with subsequent morphological study of 211-five of them the diagnosis was confirmed prostate cancer. However, the efficiency, specificity, and accuracy of the initial diagnosis, exhibited on the basis of PSA, was 94.7%, 10.4% and 32.8% respectively, while the same parameters for preliminary diagnosis based on the CWR respectively 96,1%, 22.7% and 42.2 per cent.
Example 1. Patient C., 57 years old, complains of lethargy stream when urinating and day pollakiuria. The level of total PSA blood of 8.2 ng/ml, which allows to suspect the presence of PRV in a given patient.
Calculated by the formula
which is less than the proposed threshold value of 0.2, which indicates a low probability of FPW for this patient. The patient was multifocal spectacle biopsy mud. Morphological study did not confirm the existing suspicion on PC.
Example 2. Patient B., 65 years old, complains of difficulty in urination, lethargy jet and night pollakiuria. The level of total PSA blood of 6.1 ng/ml Calculated by the formula
greater than the threshold meant what I 0,2, that indicates a high probability PC for this patient. The patient was multifocal spectacle biopsy mud, exhibited morphological diagnosis FPW II Art.
Thus, the use of the method for the diagnosis of prostate cancer can serve as a reliable test to suspect prostate cancer even when levels of free PSA blood within the "grey zone", i.e. when the PSA level from 4 to 9.9 ng/ml Method is simple to perform, can significantly reduce the number of unwarranted biopsies of the prostate and reduce the cost of performing multi focal biopsy of the prostate with subsequent morphological study of biopsy material.
A method for diagnosing prostate cancer, comprising determining PSA, characterized in that the counting criterion probability of prostate cancer according to the formula:
where e is the base of natural logarithm (e=2,718...);
PSA - level of total PSA blood in ng/ml;
V - the patient's age in years;
and when CWR more than 0,2 patient is prescribed multifocal spectacle biopsy of the prostate.
FIELD: medicine, juvenile clinical nephrology.
SUBSTANCE: disease duration in case of obstructive pyelonephritis should be detected by two ways: either by detecting the value of NADPH-diaphorase activity, as the marker of nitroxide synthase activity in different renal department and comparing it to established norm, or by detecting clinico-laboratory values, such as: hemoglobin, leukocytes, eosinophils, urea, beta-lipoproteides, lymphocytes, neutrophils, the level of glomerular filtration, that of canalicular reabsorption, urinary specific weight, daily excretion of oxalates, arterial pressure, and estimating their deviation against average statistical values by taking into account a child's age.
EFFECT: higher efficiency of detection.
7 dwg, 1 ex, 6 tbl
FIELD: medicine, clinical toxicology.
SUBSTANCE: at patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.
EFFECT: higher accuracy of prediction.
2 ex, 3 tbl
SUBSTANCE: method involves carrying out microscopic examination of blood serum samples taken from femoral vein and cubital vein. Femoral vein sample is taken on injured side. The examination is carried out before and after treatment. The blood serum samples are placed on fat-free glass slide in the amount of 0.01-0.02 ml as drops, dried at 18-30°C for 18-24 h. The set of pathological symptoms becoming larger or not changed after the treatment in comparison to sample taken before treatment, and morphological picture of samples under comparison taken from the cubital vein showing no changes or being changed to worse, the treatment is considered to be effective.
EFFECT: enabled medicamentous treatment evaluation in course of treatment to allow the treatment mode to be changed in due time; avoided surgical intervention (amputation); retained active life-style of aged patients.
FIELD: medicine, biotechnology, pharmacy.
SUBSTANCE: invention relates to agents used for treatment of pathological states associated with disorder of synthesis of neuromediating substances. Method involves the development of pharmaceutical composition and a method for it preparing. Pharmaceutical composition represents subcellular synaptosomal fractions: synaptic membranes, "light" synaptosomes and "heavy" synaptosomes prepared from gray matter of cerebral hemispheres from experimental animals based on the goal-seeking modification of humoral mediators of nerve endings transformed to synaptosomes in development and regression of malignant processes. The composition provides inhibiting the growth of tumor cells, to elevate span-life of patients with ascite Ehrlich's sarcoma, breast adenocarcinoma Ca-755, Wolker's carcinosarcoma-256.
EFFECT: valuable medicinal and anti-tumor properties of composition.
12 cl, 3 tbl, 3 ex
FIELD: medicine, phthisiology, microbiology.
SUBSTANCE: diagnostic material is poured preliminary with chlorohexidine bigluconium solution, homogenized, kept at room temperature for 10-12 h and centrifuged. Precipitate is poured with Shkolnikova's liquid medium, incubated at 37oC for 3 days, supernatant part of Shkolnokova's medium is removed, fresh Shkolnikova's medium is added, and precipitate is stirred and inoculated on the dense cellular egg media. Sensitivity of the strain is determined in 3 weeks by the presence of growth in the control tube only. Invention provides enhancing precision and reducing time for assay. Invention can be used in assay for medicinal sensitivity of tuberculosis mycobacterium.
EFFECT: improved assay method.
FIELD: molecular biology.
SUBSTANCE: the suggested innovation deals with the fact that nucleic acids should be isolated directly out of the sample without pipetting stage but with the help of interconnected reservoirs being prepared beforehand. The above-mentioned vessels should be applied either separately or being interconnected according to standard microtitrating format. The sample should be mixed with a lyzing buffer and nucleic acids are bound with matrix in closed system including, at least, two interconnected reservoirs. Forced movement of sample's mixture and buffer back and forth from one reservoir into another one for several times through narrow passage provides their thorough intermixing. The method provides quick and safe isolation of nucleic acids.
EFFECT: higher efficiency.
44 cl, 4 dwg, 1 ex
FIELD: medicine, urology.
SUBSTANCE: one should conduct subcutaneous prevocational tuberculin test and, additionally, both before the test and 48 h later it is necessary to perform the mapping of prostatic vessels and at decreased values of hemodynamics one should diagnose tuberculosis. The information obtained should be documented due to printing dopplerograms.
EFFECT: more reliable and objective information.
1 ex, 1 tbl
FIELD: medicine, psychiatry.
SUBSTANCE: one should isolate DNA out of lymphocytes of peripheral venous blood, then due to the method of polymerase chain reaction of DNA synthesis one should amplify the fragments of hSERT locus of serotonin carrier gene and at detecting genotype 12/10 one should predict the risk for the development of hallucino-delirious forms of psychoses of cerebro-atherosclerotic genesis.
EFFECT: more objective prediction of disease development.
SUBSTANCE: method involves carrying out physiological examination with electroencephalogram recorded. Cognitive evoked potential method is additionally applied as neuropsychological examination for detecting hard and latent organic brain lesions causing central nervous system pathological disorders. An additional psychophysiological examination is carried out with vision analyzer test, visuomotor response test being applied for obtaining estimations of selection, discrimination, noise immunity and muscle endurance index, movement coordination, response to moving object and integral estimation of attention and ability for perceiving significant information, motor analyzer rapid response production estimation, estimation of nature of cardiovascular system response to given psychoemotional loading estimation. The examination is sequentially carried out as primary control when hiring personnel, as intermediate control in following a training course and emergency training. Psychological testing is of multi-purpose nature. To achieve it, a set reliable tests and methods of prognostic and substantial validity are applied, including intellect and project-building tests and standardized self-reports. When making decisions concerning professional validity based on test and examination results, risk group is selected from operation personnel.
EFFECT: enhanced effectiveness of occupational skill assessment.
SUBSTANCE: method involves carrying out urological examination for determining hydrodynamic resistance of ureter calculated from formula Z=8Lμ/(πR4), where Z is the hydrodynamic resistance of ureter, L is the ureter length, R is the ureter radius, μ is the urine viscosity. Angle α at which the ureter enters the urinary bladder is determined from formula cosα = 8l1μ/(ZπR4), where l1 is the perpendicular drawn from the upper edge of the ureter to the its exit projection line, μ is the urine viscosity, Z is the hydrodynamic resistance of ureter, R is the ureter radius. Vesicoureteral reflux recidivation is predicted when the angle of α+90° is less than 120°.
EFFECT: enhanced effectiveness in reducing the number of recidivation cases.
2 dwg, 1 tbl
SUBSTANCE: method involves measuring intraocular pressure. Static computer-assisted perimetry method is used in a way that luminous spot serves as test object. The spot acts upon eye in various vision field points with threshold brightness and then in growing sequence. Eye retina light-sensitivity is measured in vision field points under study. The number of points is set with patient examination program. Total light-sensitivity is measured in decibels. Medicamentous reduction of intraocular pressure is achieved with 0.5% Ocupress solution introduced as drops twice with 5-6 min long interval. The intraocular pressure being reduced at least by 4 mm of mercury column, repeated static perimetry examination is carried out. Total light-sensitivity being increased less than by 50 dB, individual initial intraocular pressure tolerance conclusion is drawn. Total light-sensitivity being increased by 50 dB or more, individual initial intraocular pressure intolerance conclusion is drawn.
EFFECT: enhanced effectiveness in determining intraocular pressure tolerance/intolerance.
FIELD: medicine; medical engineering.
SUBSTANCE: method involves collecting information and storing it in single database or several databases representing parameter values of significance to enable one to carry out the procedures on his/her own, and operations for processing the mentioned single database or several databases to show alternative variants for making selection among two or more actions and values corresponding to each of two or more actions. Device has means for making calculations, required for implementing the method, and computer system and machine-readable carrier having program written on it and capable of implementing the method corresponding to the invention, on computer.
EFFECT: wider range of means accessible to end user.
69 cl, 8 dwg, 1 tbl
SUBSTANCE: method involves carrying out ultrasonic scanning examination of subclavian artery over its whole extent in physiological arm position with arterial blood pressure being measured in the middle one third of the arm. Next, when applying compression tests, blood circulation parameters variations are recorded in distal segment of the subclavian artery with arterial blood pressure being concurrently measured. Three degrees of superior thorax aperture syndrome severity are diagnosed depending on reduction of linear blood circulation velocity and arterial blood pressure compared to their initial values. Mild one takes place when linear blood circulation velocity reduction reaches 40% and arterial blood pressure 20% of initial level, moderate one when linear blood circulation velocity reduction reaches 70% and arterial blood pressure 50% and heavy one when linear blood circulation velocity reduction is greater than 70% of initial level and arterial blood pressure is greater than 50% to the extent of no blood circulation manifestation being observed in the subclavian artery.
EFFECT: high accuracy of diagnosis.
SUBSTANCE: method involves evaluating proliferating processes by calculating index of positive cell nuclei (Ki-67). The Ki-67 value being from 6 to 16%, erosive ulcerating stomach lesions accompanied by stomach hemorrhage and hemorrhagic shock is to be predicted. The value being from 17 to 30%, erosive ulcerating stomach lesions without hemorrhage is to be predicted.
EFFECT: high accuracy of prognosis.